Surgical procedures for connecting an anastomotic prosthesis to biological tissue, such as a blood vessel and the heart, have required manually suturing the prosthesis to the tissue. Manual suturing can be difficult due to limited access to, location of, and/or type of tissue. As an alternative or a compliment to manual suturing, an applicator tool can be used to deploy clips, sutures, and/or other types of securement for connecting the prosthesis to the tissue. The applicator tool can be used during minimally invasive surgery. During one type of minimally invasive surgery, a small hole or port may be created through the patient's body to give the surgeon access from outside of the body into a body cavity. The surgeon can have limited visibility of the target site and limited space for operation. Thus, the applicator tool can help to connect the surgeon to this target site and provide a constant connection with the target site to perform the targeted procedure.
When using an applicator tool, tissue may shift in position and/or move away from the applicator tool, which makes it difficult to accurately place the prosthesis at the desired location and to deploy the securement into the tissue. For example, when the tissue is a blood vessel or the heart, pulsatile blood flow may cause the tissue to shift in position. Even when blood flow is temporarily blocked or bypassed, the wet and slippery tissue may be pushed away instead of being pierced by the securement being deployed by the applicator tool. Even if surrounding tissue is secured, such as with temporary sutures, to a fixed structure like a surgical bed or a sternum retractor used to hold open the chest cavity, the tissue and applicator tool may still move relative to each other while the applicator tool is held by the surgeon. Relative movement between the tissue and applicator tool can cause inaccurate deployment of securement by the applicator tool.
There is a continuing need to make the procedure for connecting a prosthesis to tissue easier and faster to perform. There is also a need to engage an applicator tool to tissue during deployment of securement by an applicator tool.